Healthcare Provider Details

I. General information

NPI: 1568098515
Provider Name (Legal Business Name): CHRISTINE HAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41990 COOK ST # F1004
PALM DESERT CA
92211-6100
US

IV. Provider business mailing address

41990 COOK ST # F1004
PALM DESERT CA
92211-6100
US

V. Phone/Fax

Practice location:
  • Phone: 760-565-5545
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE6203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: